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Dementia and nutrition


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Dementia and nutrition

  1. 1. Nutrition: It’s More than A Meal Mary Ann Johnson, MA Program Director Alzheimer’s Association, Greater Richmond
  2. 2. GOALS AND OBJECTIVES <ul><li>State importance of good nutrition for the person with a dementia disease and their care partner </li></ul><ul><li>State healthy habits to encourage good nutrition </li></ul><ul><li>Identify cooking tips to add vitamins to foods and supplements to promote good nutrition </li></ul><ul><li>State the importance of exercise and socialization to aid in good nutrition </li></ul>
  3. 3. Research around the world is reporting that good nutrition, socialization and exercise are important not only for the person diagnosed with dementia but also for the care partner.
  4. 4. We often think of mealtime as breakfast, lunch and dinner – a way to satisfy the body because of hunger. MEALTIME IS: <ul><li>a time for satisfying hunger </li></ul><ul><li>a social time </li></ul><ul><li>a celebration </li></ul><ul><li>a time to provide the body with the vitamins and nutrients it needs. </li></ul>
  5. 5. One of the biggest challenges for the care partner of someone with dementia is to assure that the person has a balanced diet and is hydrated . It may also be a challenge for the care partner to have a balanced diet.
  6. 6. “ A healthy diet is only as good as the food that is eaten.” Food for Thought Fact Sheet, Alzheimer’s Society UK
  7. 7. A healthy diet can be all foods in moderation, but they should be those which the person likes.
  8. 8. <ul><li>In the early stages of the disease, people often lose interest in food because of depression . </li></ul>
  9. 9. Eating for the person with dementia may be affected by: <ul><li>environment </li></ul><ul><li>depression </li></ul><ul><li>medications </li></ul><ul><li>physical illness </li></ul><ul><li>physical discomfort </li></ul><ul><li>lack of exercise </li></ul><ul><li>damage to the brain </li></ul><ul><li>constipation </li></ul><ul><li>difficulties with chewing and swallowing </li></ul><ul><li>inability to taste or smell the food. </li></ul>
  10. 10. AS THE DISEASE PROGRESSES, PEOPLE WITH DEMENTIA MAY: <ul><li>forget to eat </li></ul><ul><li>forget that they had eaten and then eat too much of the wrong foods by snacking </li></ul><ul><li>forget how to prepare their food </li></ul><ul><li>eat spoiled or rotten food </li></ul><ul><li>forget to drink liquids. </li></ul>
  11. 11. <ul><li>Poor fitting dentures may cause a person to refuse food. </li></ul><ul><li>Mouth sores can also make eating uncomfortable . </li></ul><ul><li>Regular checkups are important. </li></ul>GOOD DENTAL CARE IS IMPORTANT
  12. 12. KEEP IT SIMPLE! ENVIRONMENT Clutter and noise are distracting. GOURMET (not Buffet)!
  13. 13. KEEP IT SIMPLE : <ul><li>Serving mini meals throughout the day may be helpful. </li></ul><ul><li>Small portions on the plate do not overwhelm the person. </li></ul><ul><li>Food served one thing at a time, or in courses, may also be helpful. </li></ul><ul><li>It is important to serve food in an attractive presentation. </li></ul><ul><li>Solid color table cloths </li></ul><ul><li>A contrasting plate </li></ul><ul><li>Serve food in a bowl or plate that they can see, i.e., a red bowl with macaroni and cheese </li></ul><ul><li>Keep decorations at a minimum </li></ul><ul><li>Condiments should not be left on the table. </li></ul>
  14. 14. MEALTIME CAN BE A SOCIAL EVENT <ul><li>Most people do not like to eat alone. </li></ul><ul><li>For the person with dementia, this provides the care partners a time to slow down and enjoy companionship with their loved one. </li></ul><ul><li>Invite the person to join you. </li></ul><ul><li>Sit down with them. </li></ul><ul><li>Have a simple but friendly conversation, reminisce about good times in the past. </li></ul><ul><li>Keep the conversation light. </li></ul><ul><li>Remember HUMOR! Laughter is good. </li></ul><ul><li>Find something to celebrate. </li></ul>
  15. 15. MAINTAIN DIGNITY <ul><li>A covering for the clothing may be needed. </li></ul><ul><li>When it becomes difficult to use knives and forks, finger foods may be more helpful. </li></ul><ul><li>Soups and cereals can be served in a mug with two handles. </li></ul><ul><li>Drinks can also be served in a cup with a handle. </li></ul>
  16. 16. HYDRATION IS IMPORTANT <ul><li>Staying healthy means drinking eight cups of fluid each day, unless there is a medical problem that prohibits this. </li></ul><ul><li>Individuals with Alzheimer’s tend to have less of a &quot;thirst drive&quot;; therefore it is good to encourage them to drink regularly and to observe urine color to ascertain hydration status. </li></ul>
  17. 17. Know the person that you are caring for, his/her likes and dislikes, his/her favorite foods.
  18. 18. HOW CAN WE STIMULATE THE APPETITE? <ul><li>Exercise may increase the appetite. </li></ul><ul><li>Healthy snacks between meals. </li></ul><ul><li>Food texture. </li></ul><ul><li>Be aware of health problems. </li></ul><ul><li>Sauces on food may help. </li></ul><ul><li>Some medications may make the mouth dry and may also take away the appetite. </li></ul><ul><li>Make the plate appealing. </li></ul><ul><li>Involve the person in meal preparation. </li></ul><ul><li>The sense of taste may need a jump start. Try using spices to increase food flavor. </li></ul><ul><li>A little sugar or sweetener may make the food more appealing. </li></ul><ul><li>A glass of juice before meal time, served in a cocktail glass may increase the appetite. </li></ul><ul><li>Eat dessert first. </li></ul>
  19. 19. OTHER SUGGESTIONS <ul><li>Cold food is unappetizing, an insulated plate may help keep food at the appropriate temperature. </li></ul><ul><li>Positive encouragement and reminders redirect the person’s attention back to their food. </li></ul><ul><li>Presentation is important. </li></ul><ul><li>Foods that are difficult to eat should be avoided. </li></ul><ul><li>Adaptive utensils may be helpful to maintain independence. </li></ul><ul><li>A sip of liquid between bites may help or using sauces on the food, when dry mouth is a problem. </li></ul>
  20. 20. SOME SUGGESTIONS WHEN WEIGHT LOSS BECOMES AN ISSUE: <ul><li>Talk to your physician about nutritional supplements </li></ul><ul><li>Fix cooked cereals with milk or cream. </li></ul><ul><li>Prepare a shake with ice cream, milk and add instant breakfast mix or liquid supplements, like ensure. </li></ul><ul><li>Serve yogurt and pudding as a snack. </li></ul>
  21. 21. REMEMBER THAT A WELL BALANCED DIET IS IMPORTANT <ul><ul><li>Milk and Dairy- we need vitamin D </li></ul></ul><ul><ul><li>Meat, Fish and Alternatives- meat, poultry, fish, eggs, nuts, beans, lentils, tofu. These are good sources for iron, Vitamin B and Folate. </li></ul></ul><ul><ul><li>Bread, cereals and potatoes - good sources for vitamin B. </li></ul></ul><ul><ul><li>Fruits and vegetables - add fiber as well as vitamins </li></ul></ul><ul><ul><li>Fats, oils and other foods - in small amounts. These are necessary to aid in digestion. </li></ul></ul>
  22. 22. FIBER IN THE DIET IS IMPORTANT <ul><li>Helps prevent constipation </li></ul><ul><li>You can get fiber from fruits, vegetables, salads, beans, lentils and whole grain cereals and bread. </li></ul><ul><li>Do not add raw bran to foods. It may cause bloating and discomfort and inhibit the absorption of nutrients such as calcium and iron </li></ul>
  23. 23. SNACK FOODS <ul><li>Try to pick healthy foods such as fruits, peanut butter and graham crackers. </li></ul><ul><li>Remember, a small glass of juice at snack time may help in keeping the person hydrated. Jell-O or pop sickles will also aid in hydration. </li></ul><ul><li>High sugar snacks are not the best. </li></ul><ul><li>Ice cream and puddings can provide calcium and B12. </li></ul>
  24. 24. AS THE DISEASE PROGRESSES: <ul><li>Swallowing and chewing may become difficult. </li></ul><ul><li>Soft foods may help. </li></ul><ul><li>Ask your physician about getting assistance from a speech therapist for swallowing difficulties. </li></ul><ul><li>Textures are important. </li></ul>
  25. 25. KEEP FOODS SIMPLE! Breads and Cereals: buttered toast, small sandwiches, muffins, crackers with cheese, biscuits Meat Fish and Alternatives : meat sliced and cut in pieces chicken breast, cut in small pieces hard boiled eggs, quartered fish sticks, crab cakes hamburger hot dog Fruit: Slices of pear, apple, or melon, orange sections, seedless grapes, bananas cut into slices (maybe add a bit of peanut butter), strawberries Vegetables: Broccoli florets, cauliflower florets, green beans, cherry tomatoes, celery sticks, potato wedges, boiled potatoes ( don’t forget sweet potatoes are a good source of vitamin C)
  26. 26. SNACK AND SANDWICH SUGGESTIONS <ul><li>SANDWICH SUGGESTIONS </li></ul><ul><li>Egg, chicken or tuna salad </li></ul><ul><li>Soft sliced cheese </li></ul><ul><li>Peanut butter </li></ul><ul><li>SNACK SUGGESTIONS: </li></ul><ul><li>Milk Shakes made with ice cream and instant breakfast drink </li></ul><ul><li>Jell-O </li></ul><ul><li>Pudding </li></ul><ul><li>Crackers and soft cheese or peanut butter </li></ul><ul><li>Fruit wedges </li></ul><ul><li>Ice cream </li></ul><ul><li>Fruit juices </li></ul><ul><li>Flavored water </li></ul>
  27. 27. Mealtime provides socialization as well as nutrition. WE All NEED BOTH!
  28. 28. Bon Appetit!
  29. 29. <ul><li>The Alzheimer’s Association </li></ul><ul><li>4600 Cox Road </li></ul><ul><li>Glen Allen, VA 23060 </li></ul><ul><li>Telephone 804-967-2580 </li></ul><ul><li>Helpline 800-272-3900 </li></ul><ul><li> </li></ul>
  30. 30. Resources <ul><li>Learning to Speak Alzheimer’s by Joanne Koenig Coste. </li></ul><ul><li>Alzheimer’s Society, UK, “Food for Thought” fact sheet. </li></ul><ul><li>Alzheimer’s Society, UK, “Tips for Carers” </li></ul><ul><li>“ Planning Guide for Dementia Care at Home: A Reference Tool for Care Managers,” The Alzheimer’s Association, South Central Wisconsin Chapter, The Wisconsin Alzheimer’s Institute and the Wisconsin Bureau of Aging and Long Term Care Resources, Division of Disability and Elder Services Department, PDE-3195 </li></ul>